Provider Demographics
NPI:1649574997
Name:FERENZ, JODI VENERUSO (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:VENERUSO
Last Name:FERENZ
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2441
Mailing Address - Country:US
Mailing Address - Phone:215-906-5566
Mailing Address - Fax:
Practice Address - Street 1:105 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2441
Practice Address - Country:US
Practice Address - Phone:215-906-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010024225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics